1.Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025)
Lunxu LIU ; Shugeng GAO ; Jianxing HE ; Jian HU ; Di GE ; Hecheng LI ; Mingqiang KANG ; Fengwei TAN ; Fan YANG ; Qiang PU ; Kaican CAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(03):281-290
Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.
2.Research progress of super-pulse fiber thulium laser lithotripsy
Tianfu DING ; Zhongyue HUANG ; Zheng XU ; Jianxing LI
Journal of Modern Urology 2025;30(1):82-85
Super-pulse thulium fiber laser (hereinafter referred to as thulium laser) has shown broad application prospects in medical research, especially in the treatment of urinary tract stones.Thulium laser has a thin fiber diameter, which reduces the occupation of the working channel and increases the irrigation water flow.Currently, the peak power reaches up to 500 W, the single pulse energy to 6 J, and the frequency to 2000 Hz.The stone-breaking mechanism of thulium laser is photothermal and photomechanical.Different combinations of energy and frequency will significantly affect the volume of stone fragments. "High energy and low frequency" is more suitable for "fragmentation" stone breaking, while "low energy and high frequency" is more suitable for "powderization" stone breaking.Some in vitro experiments have confirmed that thulium laser has higher stone-breaking efficiency, less stone displacement, and more obvious thermal effects compared to holmium laser.Clinically, thulium laser has been applied to ureteroscopic lithotripsy and percutaneous nephrolithotomy., and the stone free rate and safety are relatively high.This article reviews the stone-breaking principles, in vitro experiments, and clinical applications of thulium laser, aiming to provide better theoretical support and practical experience for the development and application of super-pulse thulium fiber laser in the future.
3.Establishment of HPLC fingerprint and content determination of Gerbera delavayi
Lisha SUN ; Li JIANG ; Li LI ; Lin TIAN ; Yang WANG ; Jie PAN ; Yueting LI ; Yongjun LI
China Pharmacy 2025;36(9):1052-1058
OBJECTIVE To establish the fingerprint of Gerbera delavayi and the methods for the content determination of 11 components in G. delavayi. METHODS High-performance liquid chromatography(HPLC)was adopted to establish the fingerprints of 13 batches of G. delavayi(No. S1-S13), and the similarities were evaluated according to Similarity Evaluation System of Chromatographic Fingerprint of TCM (2012 edition), while the common peaks were identified. Hierarchical clustering analysis (HCA), principal component analysis (PCA) and orthogonal partial least square-discriminant analysis (OPLS-DA) were carried out by using SPSS 25.0 software and SIMCA 14.1 software. The contents of neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, 3,8-dihydroxy-4-methoxy-2-oxo-2H-1-benzopyran-5-carboxylic acid, caffeic acid, 3-hydroxy-4-methoxy-2- oxo-2H-1-benzopyran- 5-carboxylic acid, luteolin-7-O-β-D-glucoside, isochlorogenic acid A, apigenin-7-O-β-D-glucoside, isochlorogenic acid C and xanthotoxin were determined by HPLC. RESULTS The similarities in HPLC fingerprint of 13 batches of G. delavayi were 0.801-0.994; a total of 38 common peaks were identified and 13 common peaks were identified. The results of HCA showed that S1-S5 and S7 were clustered into one group, S6 into one category, S8 into one category, S9 and S11 into one category, S10, S12 and S13 into one category, and the results of PCA were consistent with them. The results of OPLS-DA showed that variable importance values for the projection of peak 7 (chlorogenic acid), peak 21 (isochlorogenic acid A), peak 26 (xanthotoxin), peak 19 (isochlorogenic acid B), peak 33, peak 13, peak 23 (isochlorogenic acid C), peak 2 (new chlorogenic acid), peak 17 (luteolin-7-O-β-D- glucoside) were greater than 1. The above 11 components had good linearity in their respective detection concentration ranges (r was greater than 0.999). RSDs of precision, repeatability, and stability tests were not more than 2% (n=6). The average recovery rates were 92.54%-105.55%, and the RSDs were 0.83%-1.93% (n=6). The average contents of 11 components were 0.744, 5.014, 0.646, 0.431, 0.069, 0.582, 0.979, 2.754, 0.157, 1.284 and 2.943 mg/g, respectively. CONCLUSIONS The constructed HPLC fingerprint and content determination methods are simple, accurate and stable, which can provide reference for quality control of G. delavayi. Xanthotoxin, chlorogenic acid, isochlorogenic acid A, luteolin-7-O- β -D-glucoside, isochlorogenic acid C and new chlorogenic acid can be used as markers for G. delavayi.
4.New treatment methods for complex urinary stones: Needle-perc assisted endoscopic surgery
Journal of Modern Urology 2025;30(2):91-94
Complex urinary stones have been the focus and difficulty of clinical treatment.Traditional multi-channel percutaneous nephrolithotomy (PCNL) has a high stone-free rate and efficacy in the treatment of multiple or large volume kidney stones,but has risk of serious complications such as bleeding and injury.Retrograde intrarenal surgery (RIRS) has been preferred in the treatment of renal stones with a diameter of less than 2 cm due to its characteristics of small trauma and fast recovery.However,it is difficult to treat small calyx stones with poor anatomy,lower renal calyx stones with small IPA,and diverticulum stones.Needle-perc assisted endoscopic surgery (NAES) includes the following modes:①Needle-perc plus PCNL,which can effectively reduce the number of channels,reduce surgical risks,and protect kidney function while ensuring a high stone-free rate; ②Needle-perc plus RIRS,which can significantly improve the success rate and stone-free rate without increasing kidney damage,thus having significant advantages in dealing with complex urinary stones.In order to popularize and promote this technique,this essay will review the relevant domestic and foreign literature and the clinical experience of our center,focusing on the indications,usage specifications,operative skills and precautions of NAES.
6.Research progress on the pathogenesis of chest tightness variant asthma characterized by chest tightness
Luanqing CHE ; Jianxing LAI ; Huaqiong HUANG ; Wen LI ; Huahao SHEN
Journal of Zhejiang University. Medical sciences 2024;53(2):213-220
Chest tightness variant asthma(CTVA)is an atypical form of asthma with chest tightness as the sole or predominant symptom.The underlying receptors for chest tightness are bronchial C-fibers or rapidly adapting receptors.The nerve impulses are transmitted via the vagus nerve and processed in different regions of the cerebral cortex.Chest tightness is associated with sensory perception,and CTVA patients may have heightened ability to detect subtle changes in lung function,but such sensory perception is unrelated to respiratory muscle activity,lung hyperinflation,or mechanical loading of the respiratory system.Airway inflammation,pulmonary ventilation dysfunction(especially involving small airways),and airway hyperresponsiveness may underlie the sensation of chest tightness.CTVA patients are prone to comorbid anxiety and depression,which share similar central nervous system processing pathways with dyspnea,suggesting a possible neurological basis for the development of CTVA.This article examines the recognition and mechanisms of chest tightness,and explores the pathogenesis of CTVA,focusing on its association with airway inflammation,ventilation dysfunction,airway hyperresponsiveness,and psychosocial factors.
7.Research progress of radiomics in urolithiasis
Haifeng SONG ; Lei LIANG ; Yubao LIU ; Boxing SU ; Bo XIAO ; Weiguo HU ; Jianxing LI
Chinese Journal of Urology 2024;45(1):71-74
As a new quantitative analysis method of radiology image data, radiomics has been widely used in the diagnosis and treatment evaluation of various diseases especially malignant tumors, promoting the development of individualization and precision in disease diagnosis and treatment. In urolithiasis, radiomics is mainly used in the differential diagnosis of ureteral calculi, preoperative prediction of different calculus compositions, and prediction of efficacy of various treatment modalities. This paper introduced the basic workflow of radiomics, and reviewed its application progress in urolithiasis.
8.Hot topics and interpretation of stones in 2024 AUA annual meeting
Boxing SU ; Yubao LIU ; Weiguo HU ; Bo XIAO ; Jianxing LI
Chinese Journal of Urology 2024;45(5):339-342
At the annual meeting of American Urological Association (AUA), the field of urinary stone involved many directions such as basic research, drug treatment, surgical intervention, and so on. The results of many expected large-scale multicenter randomized controlled clinical trials were also revealed at the congress. Image navigation technology, artificial intelligence, and machine learning algorithms were further applied in the field of stone diagnosis and treatment.
9.Clinical study and efficacy evaluation of Needle-perc combined with RIRS in the treatment of complex calyceal diverticular stone
Yubao LIU ; Bo XIAO ; Weiguo HU ; Gang ZHANG ; Meng FU ; Boxing SU ; Yuzhe TANG ; Haifeng SONG ; Bixiao WANG ; Zhichao LUO ; Jianxing LI
Chinese Journal of Urology 2024;45(6):461-466
Objective:To retrospectively analyze and summarize the clinical experience and therapeutic effect of anterograde Needle-perc combined with RIRS, namely N+ R (Needle perc + RIRS) technique in the treatment of complex calyceal diverticular stone.Methods:Retrospective analysis of 23 cases of complex renal caliceal diverticulum stones admitted to our hospital from January 2020 to December 2022. The complex factors mainly include the invisible cervical orifice of diverticulum, large stone volume, and special anatomical location, which makes single RIRS or PCNL treatment difficult or unsuccessful. There were 14 males and 9 females with an average age of (42.3±6.1) years. Three cases were upper calyceal diverticular stone, average size was (0.9±0.2)cm. Nine patients had diverticular stone in the middle posterior calyx, and the average size was (1.2±0.3)cm. The average size of four diverticular stone was (1.8±0.2)cm in the anterior middle calyx. Seven patients had diverticular stone with an average size of (1.3±0.1)cm in lower calyx. Among them, 12 patients underwent RIRS which were difficult or stone undiscovered, and 3 patients underwent PCNL and the operation was terminated due to failure of channel establishment. In our center, oblique supine lithotomy position (male) or prone split-leg position (female) was adopted, and the combined treatment of Needle-perc and RIRS was performed. Needle-perc puncture was completed under the guidance of full ultrasound. During the operation, methylene blue reagent or mutual guidance of two endoscopes was used to find the diverticulum neck and expand the outlet with holmium laser incision. Depending on the size and location of the stones, a single Needle-perc laser lithotripsy combined with stone removal in flexible ureteroscope was used, or dual lasers were be used simultaneously for stone removal under double endoscopes. The first stage stone free rate, operation time, hemoglobin decrease, complications, postoperative hospital stay and other conditions were analyzed.Results:All the 23 operations were completed successfully. The stone free rate within 48 hours and one month after surgery was 78.2% and 100.0% respectively. The average operation time was (61.5±12.2)min. The mean postoperative hospital stay was (2.8±0.6) days. The mean decrease of hemoglobin was (3.6±0.4)g/L. Three patients had fever and one patient had renal subcapsular effusion. After anti-inflammatory and symptomatic treatment, the patient was discharged. There was no incidence of Clavien-Dindo≥Ⅱcomplications such as blood transfusion, abdominal organ injury or urosepsis.Conclusions:Treatment of complex renal caliceal diverticulum stones using N+ R technique of anterograde needle-perc combined with RIRS can effectively improve the success rate of first-stage surgery. Overall, it is safe, efficient and feasible with the advantages of high stone free rate, lower damage, and few postoperative complications.
10.Needle-perc assisted endoscopic surgery for treatment of staghorn kidney stone: a case report with surgical video
Yubao LIU ; Yangyang XU ; Haiwen HUANG ; Jianxing LI
Chinese Journal of Urology 2024;45(8):624-625
Percutaneous nephrolithotomy(PCNL) has always been the first-line minimally invasive treatment for staghorn kidney stones, with high surgical efficiency and first-stage stone free rate. However, due to the complexity of stones and the difficulty of surgery, serious complications such as postoperative bleeding, infection, and renal function damage often occur. Needle-perc assisted endoscopic surgery(NAES) surgery, also known as needle-perc assisted endoscopic surgery, is an innovative model based on needle-perc proposed by our center. The S+ N mode is standard tract PCNL combined with needle-perc, which not only improves the efficiency and stone free rate, but also reduces the number of tracts, effectively protecting renal function and reducing complications. This article reports a case of complete staghorn kidney stones that were completely removed by NAES surgery in one stage, with no complications after surgery and the patient recovering quickly and being discharged from the hospital.

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